DESCRIPTION: (Applicant's Abstract) Discrimination against transgendered individuals can make their access to health services highly problematic. More specifically, substance use treatment programs may not be sensitive to transgendered individuals who have drug use problems. Because of this, the needs of transgendered individuals may go unmet. As indicated in a resolution recently passed by the American Public Health Association (March, 2000), a knowledge base must be built to aid substance use service providers in developing policies to increase their effectiveness when working with transgendered men and women. This study will examine (a) factors that influence transgendered men and women's substance use, (b) problems that may hinder their access to substance use treatment, and (c) problems they may face within such programs. I will distribute confidential, self-administered questionnaires to transgendered men and women in Los Angeles and San Francisco (two areas with large concentrations of transgendered men and women). The recruitment strategy will utilize outreach and treatment organizations serving transgendered individuals, advertising in local newspapers and magazines, and respondent driven sampling. The chief analytic task is to examine relationships between people's experiences of discrimination and physical/verbal abuse due to being transgendered, their experience in substance use treatment and other health services, and their substance use history. As this is an exploratory study, much of the analysis will be bivariate. Hypotheses: 1. Experience of physical/verbal abuse and discrimination will be positively associated with substance use. 2. Experience of physical/verbal abuse and discrimination will be negatively associated with participation in treatment. 3. Experience of physical/verbal abuse and discrimination will be negatively associated with treatment engagement. 4. Receiving transgender-specific services will be positively associated with participation in treatment. 5. Receiving transgender-specific services will be positively associated with treatment engagement.